3.

Calculation of doses and

formulas

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Calculation of doses

 Dose is the amount of a drug administered or taken by a patient for the

intended medicinal effect.
 The dose may be expressed as a single dose, a daily dose; or a total dose
 Single Dose is the amount of drug taken at one time.
 This can be expressed as;
 the weight of drug (e.g. 250 mg of tablet),
 the volume of solution of drug (e.g. 10 mL, 2 drops, etc).
 Total dose is the total amount of drug taken during the course of therapy.
 Dosage regimen is the schedule of dosing.
 For example, four times per day for 10 days.
• A daily dose may be subdivided and taken in divided doses, two or
more times per day dependingkdon the characteristics of the drug 2
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 Factors Influencing Drug Dosing
1. Biochemical and Pharmacologic Activity
 The mechanism of action and the potency of the drug play crucial roles
in determining the effective dose.
2. Physical and Chemical Properties
 Solubility, stability, and absorption characteristics affect how much of a
drug is needed to achieve therapeutic effects.
3. Dosage Form
 Different forms (e.g., tablet, injection, patch) can alter the
bioavailability and release rate of the drug.
4. Route of Administration
 Oral, intravenous, intramuscular, and other routes have different
absorption rates and bioavailability, influencing the required dose.
5. Patient Factors
 Age, weight, gender, organ function (like liver and kidneys), and
genetic factors can affect drug metabolism and response.
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 Patient-Specific Factors Influencing Drug Dosing
1. Age
 Pediatric Patients: Often require lower doses due to immature
organ systems.
 Elderly Patients: May have altered pharmacokinetics (absorption,
distribution, metabolism, excretion) due to physiological changes.
2. Weight
 Dosing can be calculated based on total body weight or ideal body
weight, especially for medications with narrow therapeutic
windows.
3. Body Surface Area (BSA)
 BSA is often used for calculating doses of chemotherapy and other
medications, providing a more accurate estimation of drug
distribution.
4. General Physical Health
 Overall health status can influence how the body processes drugs.
01/21/2025Chronic illnesses may affect kd
metabolism and excretion. 4
4.Liver Function

 The liver is crucial for drug metabolism. Impaired liver function can lead to

drug accumulation and toxicity, necessitating dosage adjustments.

5.Kidney Function

 Renal function affects drug elimination. Dosing adjustments are often

required for patients with renal impairment to avoid toxicity.

6.Severity of Illness

 The more severe the illness, the more aggressive the treatment may need to

be, potentially leading to higher doses or more frequent administration.

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 Dose measuring devices
1.Calibrated Cups
•Use: Commonly used for measuring liquid medications at home.
•Features: Marked with measurement lines for accurate dosing in
milliliters or ounces.
2.Syringes
•Use: Ideal for precise dosing, especially for small volumes or for
patients requiring specific dosages (like children).
•Features: Available in various sizes, often marked in milliliters
(mL) or units (for insulin).
3.Intravenous (IV) Sets
•Use: Used for administering medications directly into the
bloodstream.
•Features: Often includes a drip chamber and calibrated tubing to
control flow rates.

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 Household Measurement Terms

1.Teaspoonful (tsp)
Use: Commonly used in home settings for liquid
medications.
Equivalent: Approximately 5 mL.

2.Tablespoonful (tbsp)
Use: Another household measure for larger volumes.
Equivalent: Approximately 15 mL (3 teaspoons).
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 Considerations for Accuracy

 Conversions: It's essential to know the conversions between

household measurements and metric units to ensure proper dosing.

 Education: Patients and caregivers should be educated on the

proper use of measuring devices to avoid dosing errors.

 Standardization: Whenever possible, using metric measurements

(mL) is recommended in clinical settings to minimize confusion.

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 Droppers
Drop
• Drop (abbreviated gtt) is a measure for small volumes of
liquid medications.
• Accordingly, the official dropper is calibrated to deliver
approximately 20 drops of water per milliliter (i.e., 1 mL of
water = 20 drops).
• The size of drops varies materially from one liquid to
another.
• The calibrated dropper is the only one that should be
used for the measurement of medicine.

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 Calibration of droppers

 Calibrating a dropper involves determining the volume of liquid

that each drop delivers.
 This can be done by:
1.Counting Drops:
Drops are counted as they fall into a graduated cylinder or
similar measuring device until a specific measurable volume
(e.g., 5 mL) is reached.
2.Volume Calculation:By dividing the total volume by the number
of drops, you can establish the volume per drop, which can vary
depending on the liquid's viscosity and the dropper design.
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 Common Uses of a Medicine Dropper
1.Suctioning Liquids:
 A dropper can easily suck up liquids, making it useful for
transferring medications or other solutions.
2.Dispensing Small Amounts:
 Ideal for administering small doses of medicine, particularly for
infants and small children who cannot take larger doses. This
ensures precise dosing and reduces the risk of overdose.
3.Delivering Drops to Eyes and Ears:
 Medicine droppers are frequently used to administer eye drops
or ear drops, allowing for controlled delivery of the medication
directly to the affected area.kd
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 Examples of calibrated droppers
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 Calculation of doses…
 Drug dosage calculations are required when the amount of

medication ordered is different from what is available on hand for the

nurse to administer.

 Example1: Amoxacillin 500mg PO TID for 5 days is ordered. It is

available as 250mg per capsules. How many capsules would the

pharmacist dispense?
 Ans: 30 capsules
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 Dose calculations…
 Example2: Amoxicillin is available 125mg/5ml. Amoxicillin 500mg PO is
ordered. How much should the patient administer ?
Ans: 20ml
 Example3: Furosemide is available as 20mg/2ml. Furosemide 80mg is ordered
to be administered through an IV every 12 hours. What amount should the
nurse administer once?
Ans: 4ml

• Example:- If a pharmacist counted 40 drops of a medication in filling a

graduate cylinder to the 2.5-mL mark, how many drops per milliliter did the
dropper deliver?

Soln: x = 40 (drops)/2.5 (mL)kd=16 drops/ mL

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 Calculations of number of doses

• Pharmacist often needs to calculate the size of a dose, the

number of doses, or the total quantity of medication to dispense.
• For these calculations the following equation is useful.

In using the equation, units for the total quantity and size of the dose
must be the same. Examples
Example 1. If the dose of a drug is 200 mg, how many doses are
contained in 10 g?
Soln:- 10 g = 10,000 mg, thus
 Number of doses = 10,000 (mg) = 50 doses
01/21/2025 200 (mg)/dose
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Example 2: If the dose of a medication is 150 mg,
how many doses are contained in 2.5 g?
– Solution:
1.Convert the total quantity into the same units as
the dose.
2.5 g=2,500 mg
2.Apply the formula:
Number of Doses=2,500 mg/150 mg/dose≈16.67dose

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 Drug dosage based on age

Drug dosage is a critical aspect of pharmacotherapy,

tailored to individual patient needs.
Key Patient Parameters
1. Age:
 Pediatric Patients: Dosing often requires adjustments due to
differences in metabolism and development.
 Elderly Patients: Those over 65 may need lower doses due to
altered pharmacokinetics and potential comorbidities.
2. Weight:
 Dosage calculations often use body weight, especially in pediatric
dosing, to ensure effective and safe medication use.
3. Body Surface Area (BSA):
 BSA is particularly important for chemotherapeutic agents and
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other medications where the
kd
dosages are based on metabolic rates.
19
Patient Groups Requiring Adjusted Dosages
Pediatric Patients: Dosing is often calculated using
weight or BSA to ensure safety and efficacy.
Elderly Patients: Age-related physiological changes can
affect drug metabolism, necessitating careful dosage
adjustments.
Patients with Compromised Liver or Kidney
Function:
Dosage may need to be reduced or adjusted based on the
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extent of organ impairment to prevent toxicity.
 Rules to approximate drug dose based on Age
 1. Young’s rule ( for children > 2 years):

 2. Fried’s rule ( for infants and children up to 2 years old)

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Example 1.:A liquid acetaminophen product
contains 160 mg of acetaminophen in a 5 mL dose.
The label recommends a dose of 1 teaspoonful for a
child aged 4 years. How many milligrams of
acetaminophen are contained in the child’s dose?
soln: =40mg

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Example 2.:A liquid medication contains an adult
dose of 300 mg. Calculate the appropriate dosage
for a child who is 10 months old using Fried's Rule.

Soln: =20mg

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 Calculations of Dose Based on Age
Example 3: An over-the-counter cough remedy contains 120 mg of
dextromethorphan in a 60-mL bottle of product. The label states
the dose as 11⁄2 teaspoonfuls for a child 6 years of age. How many
milligrams of dextromethorphan are contained in the child’s dose?

Solution: 11⁄2 teaspoonfuls = 7.5 mL

60 mL/120 mg = 7.5 ml/x mg

x = 15 mg dextromethorph

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 Dose based on body surface area (BSA)
 Body surface area is a method of calculating drug doses mainly for
two types of patient groups
 Cancer patients receiving chemotherapy
 Pediatric patients

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e.g 1:The height of a child is 80cm and the weight is 15kg.
The usual adult dose of Amitriptyline is 75mg/day. What
would be the dose for the child based on body surface area
(BSA)?
Soln

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E.g 2:If the adult dose of a drug is 100mg, what would be the dose
for a child with a body surface area of 0.71 m2 ?
Ans: 41mg
• Soln :
Given
• Adult Dose: 100 mg
• Child's BSA: 0.71 m²
• Average Adult BSA: approximately 1.73 m²

• =41mg

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 Drug Dosage based on Body Weight
(mg/kg)
 The usual dose is expressed as a specific quantity of drug per
unit of patient weight, such as mg/kg.
 The patient's weight is an important factor in dosing since the
size of the body influences the drug's concentration in the
body fluids and at its site of action.

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Drug dose based on body weight
 The most reliable doses are those given by the manufacturer.
 If such information is not given, the dose can be calculated using
formulae based on age, weight or surface area.
 E.g1: A child weighing 12kg is to receive 4mg/kg of phenytoin daily as
anticonvulsant. How many ml of pediatric phenytoin suspension
containing 30mg/5ml should the child receive?
 Ans: 8ml
 E.g2: The usual initial dose of chlorambucil is 150 mcg/kg of body weight.
How many milligrams should be administered to a person weighing 154
lb.?

Ans = 10.5 mg chlorambucil

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E.g 1 Ibuprofen
• Usual Dose:
• For adults: 200 to 800 mg every 6 to 8 hours as
needed, not exceeding 3200 mg/day.
• For children: 10 mg/kg per dose (up to 400 mg),
given every 6 to 8 hours as needed.

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e.g 2:Usual Dose of ceftriaxone
1. Adults:
 Uncomplicated infections:
1 to 2 grams intravenously (IV) or intramuscularly (IM) once daily.
 Severe infections (e.g., pneumonia, meningitis):
2 grams IV once daily or divided into two doses.
 Duration: Typically 7 to 14 days, depending on the type and
severity of the infection.
2. Pediatrics:
1. Neonates (0-28 days):
20 to 50 mg/kg/day IV, divided into two doses, typically not
exceeding 50 mg/kg/day.
2. Children (over 28 days):
50 to 75 mg/kg/day IV, up to a maximum of 2 grams/day.
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 Class work
1. Using the Mosteller formula, calculate the BSA for a child with a
height of 80 cm and a weight of 15 kg.
2. If the usual adult dose of Amitriptyline is 75 mg/day, calculate the
dose for a child with a BSA of approximately 0.577 m².
3. Calculate the dose for a child with a BSA of 0.71 m² if the adult
dose of a drug is 100 mg.
4. A patient weighs 20 kg. If the recommended dose of a medication
is 10 mg/kg, what is the total dose for this patient?
5. Calculate the total dose for an adult patient who requires 800 mg of
Ibuprofen every 8 hours for 24 hours.
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6.If a child needs Amoxicillin at a dose of 20 mg/kg/day and weighs
25 kg, how much total Amoxicillin should the child receive per day?
7.For a patient requiring 1.5 grams of Ceftriaxone once daily, how
many milligrams is that?
8.If the usual dose of Levothyroxine is 1.6 mcg/kg/day for a patient
weighing 70 kg, calculate the total daily dose.
9.A child is prescribed 50 mg of a medication per square meter of
BSA. If the child has a BSA of 0.5 m², what is the total dose in
milligrams?
10.If a drug is dosed at 15 mg/kg and a patient weighs 50 kg, what is
the total dose the patient should receive?
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 Thank you

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